The Prognostic Factors that Influence in Near Vision after Accommodative Intraocular Lens Implantation

PURPOSE: To evaluate the prognostic factors to determine the uncorrected near visual acuity of patients who undergone routine cataract surgery and WIOL-CF(R) (Gelmed international, Kamenne Zehrovice, Czech Republic) accommodative intraocular lens implantation. METHODS: This study evaluated 46 eyes of 27 patients who had undergone routine cataract surgery and WIOL-CF(R) accommodative IOL implantation. We checked visual acuities at near and distant before surgery. And we also checked age and gender of patients and manifest refraction, corneal astigmatism and axial length of eyes at that time. We analyzed association between these factors and uncorrected near visual acuity at postoperative 6 and 12 month. RESULTS: Univariate linear regression analyses between uncorrected near visual acuity and preoperative patients characteristics suggested that the age of patients was the only statistically significant independent variable on uncorrected near visual acuity at postoperative 6 (p < 0.001) and 12 (p < 0.001) month. Multiple regression analyses also revealed the same results (p = 0.021 at postoperative 6 month and p = 0.042 at postoperative 12 month). CONCLUSIONS: This study suggest that the age is the one of the most important prognostic factors of postoperative uncorrected near visual acuity after WIOL-CF(R) accommodative intraocular lens implantation.

Visual Outcome and Stability of Hydrogel Full-Optics Accommodative Intraocular Lens

PURPOSE: To report the visual outcome and to determine the stability of WIOL-CF(R) (GELMED, Praha, Czech Republic) hydrogel full-optics accommodative intraocular lens (IOL). METHODS: The present study evaluated 20 eyes of 10 patients who underwent routine cataract surgery and WIOL-CF(R) accommodative IOL implantation. Measurement included uncorrected/best corrected visual acuities (VA) at near and distant, degree of IOL decentration, degree of IOL tilting and anterior chamber depth on postoperative day 1, 1 month, 2 months, 6 months and 12 months. RESULTS: Result analysis was performed with 19 eyes of 10 patients, except for 1 complicated eye. At 12 months, the uncorrected distance VA of 11 eyes (57.9%) and 17 eyes (89.5%) were 20/25 and 20/40 or better, respectively. At 12 months, the uncorrected near VA of 12 eyes (63.2%) and 18 eyes (94.7%) were 20/25 and 20/40 or better, respectively. There was no statistically significant difference in anterior chamber depth (p > 0.05), IOL decentration (p > 0.05) and IOL tilting (p > 0.05) on postoperative day 1, 1 month, 2 months, 6 months and 12 months. CONCLUSIONS: The clinical results of cataract surgery with WIOL-CF were relatively satisfactory.

Changes in Anterior Chamber Depth and Refraction after Accommodative Intraocular Lens Implantation

PURPOSE: To evaluate the change in anterior chamber depth and refraction after AT-45 implantation METHODS: Twenty-two eyes from 22 patients were enrolled in this prospective study. After phacoemulsification, AT-45 (11 eyes) and SA60AT (11 eyes) were implanted. Clinical data included anterior chamber depth and refractive error at 1 week, 1 month, 2 months and 6 months postoperatively. The correlation between anterior chamber depth change and spherical equivalent change was also evaluated. RESULTS: In the AT-45 implanted group, the mean anterior chamber depth was 4.56+/-0.59 mm at 1 week postoperative, 4.70+/-0.69 mm at 1 month postoperative, 4.78+/-0.71 mm at 2 months postoperative and 4.76+/-0.69 mm at 6 months postoperative. The mean spherical equivalent was -0.53+/-0.48D, -0.37+/-0.42D, -0.27+/-0.47D, and -0.33+/-0.44D respectively. When analyzed using the Mann-Whitney U test, p-values of anterior chamber depth differences between the 2 groups were P=0.52 at 1 week to 1 month, P=0.32 at 1 month to 2 months, P=0.89 at 2 months to 6 months, and P=0.02 at 1 week to 6 months, showing a deeper anterior chamber in the AT-45 implanted group. P-values (Mann-Whitney U test) of spherical equivalent differences between the 2 groups were P=0.33, P=0.56, P=0.94, and P=0.19, respectively, showing more hyperopic change in the AT-45 implanted group. The correlation between anterior chamber depth change and spherical equivalent change in the AT-45 implanted group at 1 week to 6 months was not statistically significant (Spearman correlation analysis, P=0.223). CONCLUSIONS: Anterior chamber depth deepening and associated hyperopic refractive change were observed after AT-45 implantation, especially at 1 month after the surgery.